Related Experiment Videos
Cervical spinal cord compression and the Hoffmann sign.
J A Glaser1, J K Curé, K L Bailey
1Department of Orthopaedic Surgery, Medical University of South Carolina, USA.
The Iowa Orthopaedic Journal
|January 30, 2002
Summary
The Hoffmann sign is not a reliable indicator for cervical spinal cord compression. This study found its predictive values to be insufficient for clinical use without other supporting evidence.
Area of Science:
- Neurology
- Orthopedics
- Spinal Surgery
Background:
- Cervical spinal cord compression requires accurate diagnostic methods.
- The Hoffmann sign is a clinical test with limited established utility in diagnosing cervical spinal cord compression.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the Hoffmann sign in predicting cervical spinal cord compression.
- To determine the sensitivity, specificity, and predictive values of the Hoffmann sign.
Main Methods:
- A consecutive series of patients with cervical spine complaints were assessed.
- The Hoffmann sign was elicited, and imaging studies were reviewed for cervical spinal cord compression.
- Compression was defined by specific imaging criteria including cord flattening and CSF obliteration.
Main Results:
- The spine surgeon's review showed a sensitivity of 58% and specificity of 78% for the Hoffmann sign.
- A blinded neuroradiologist review yielded lower sensitivity (33%) and specificity (59%).
- Positive predictive values were 62% (surgeon) and 26% (neuroradiologist), and negative predictive values were 75% (surgeon) and 67% (neuroradiologist).
Conclusions:
- The Hoffmann sign, as a standalone test, demonstrates insufficient reliability for screening cervical spinal cord compression.
- Clinical correlation with other findings is essential when considering the Hoffmann sign in patient evaluation.
- Further research may be needed to clarify the role, if any, of the Hoffmann sign in specific clinical contexts.